•In 2016, liver fibrosis and hepatic steatosis in 205,673 consecutive Chinese subjects in 291 cities of 29 provinces in mainland China and Hong Kong SAR were assessed using liver stiffness measurements (LSM) and Ultrasound Attenuation Parameter (UAP) by Fibrotouch® (Wuxi Hisky Medical Technologies Co., Ltd, Beijing China).
•Each participant had fasting blood sample collected for blood lipids, platelet count, ALT, glucose, aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT) and total bilirubin. Anthropometric measurements were collected. LSM > = 7.3kilopascals (kPa), > = 9.7kPa and > = 12.5kPa were used as cutoffs for liver fibrosis, advanced liver fibrosis and cirrhosis respectively.
•Of 175,882 subjects with reliable LSM (median 6.0, range 1-78.2, Figure 2), the proportion of subjects with clinically relevant fibrosis (LSM > = 7.3kPa), advanced fibrosis (LSM > = 9.7kPa) and cirrhosis (LSM > = 12.5kPa) was 16.4% (95%C1 16.2-16.6%), 4.4% (95%C1 4.3-4.5%) and 1.4% (95%C1 1.3-1.5%), respectively (Figure 3). Excluding subjects with missing data (n = 159,742), abnormal ALT (ALT > ULN, n = 8,311) and known hepatitis B virus (HBV) infection (HBsAg positive, n = 810), 35,287 subjects (age 45 ± 12years, 57% male, BMl 23.7 ± 3.3kg/ m2, 4% diabetes) were included in the analysis.
•Age (OR:1.02; 95%Cl:1.01-1.02), male (OR:1.5, 95%Cl:1.4-1.6), BMI (OR:1.07, 95%C1:1.06-1.09), presence of DM (OR:1.29, 95%Cl 1.1-1.5) and steatosis stage (S1[240 < UAP < 265]: OR 1.1, 95%C1.0-1.2;S2[265 < UAP < 295]: OR 1.4, 95%C1: 1.3-1.6; S3[UAP > 295]: OR 2.1, 95%C1: 1.8-2.4) were significantly associated with fibrosis (Table 1). The adjusted predicted probability of fibrosis increased per stage of steatosis, with probabilities ranging from 9.7% (95%Cl: 9.3-10.1%) in subjects with S0 to 18.3% (95%Cl: 16.4-20.3) in those with S3.
